Evaluation of catheters and metallic catheter markers as calibration standard for measurement of coronary dimension

Measurement of coronary dimension requires an accurate and reproducible dimensional reference. Angiographic catheters are frequently used for this purpose. We measured the angiographic diameters of a broad range of diagnostic and angioplasty guiding catheters by using two commonly used edge-detection algorithms. Angiographic diameters are significantly less than true catheter outer diameter. Therefore the use of contrast-filled catheters as a dimensional reference may lead to considerable error in vessel measurement with overestimation of absolute dimension. Tables of reference values for multiple catheter as calibration standard, tested under a variety of angiographic conditions. The metallic-tipped marker was found to have a better degree of reproducibility than catheters. These findings have implications for studies employing serial measurements of coronary artery dimension and for the clinical practice of estimating vessel diameter for choice of balloon size during angioplasty.     

The role of serotonin in the control of cerebral activity: studies with intracerebral 5,7-dihydroxytryptamine

Intact rats treated with centrally acting antimuscarinic (atropinic) drugs display large amplitude irregular slow waves in both the neocortex and hippocampus during behavioral immobility and some stereotyped automatic behaviors (Type 2 behavior). However, rhythmical slow activity in the hippocampus and low voltage fast activity in the neocortex occur in close correlation with spontaneous changes in posture, head movement, walking, rearing, swimming or struggling when held (Type 1 behavior). It has previously been proposed that these waveforms, jointly referred to as atropine-resistant cerebral activation (ARCA) are dependent on ascending serotonergic projections. As a further test of this hypothesis, we have studied rats in which forebrain levels of serotonin and 5-hydroxyindoleacetic acid were reduced to 3-10% of control levels as a result of multiple intrabrainstem injections of 5,7-dihydroxytryptamine. This treatment strongly reduced or abolished ARCA in most cases but did not reduce atropine-sensitive cerebral activation which appears to be dependent on ascending cholinergic projections from the basal forebrain to the cerebral cortex. Therefore, ARCA appears to be dependent on ascending serotonergic inputs to the forebrain.     

Clinical analysis of 13 cases with Burkitt lymphoma or Burkitt-like lymphoma

Objective  

To summarize the clinical characteristics and treatment effects of Burkitt lymphoma (BL) and Burkitt-like lymphoma (BLL), and to explore the best possible optimal regimens and the treatment-related complications.     

Universal rubella vaccination programme and maternal rubella immune status: A tale of two systems

Maternal rubella status was compared between local residents with non-residents who delivered in our hospital during 1998–2008. Among the 60,822 women, non-immunity was more common in the non-residents (19.9% versus 8.1%, P < 0.001). Significant difference and positive correlation with age and parity were found for both groups, but a significant inverse correlation with year-of-birth was found only in the residents. Regression analysis confirmed that birth after 1970 was associated with reduced odds of non-immunity, which indicated that the rubella vaccination programme, introduced since 1978, has succeeded in reducing the incidence of non-immunity to <5% in the youngest generation.     

DNA-DNA dot hybridization to detect Epstein-Barr virus in throat washings

To compare the abilities of the nucleic acid dot hybridization assay and the cord blood lymphocyte transformation assay to detect Epstein-Barr virus (EBV), we examined throat washings from healthy control subjects (nine EBV-seronegative and 51 EBV-seropositive), patients with acute infectious mononucleosis, and renal transplant recipients. The dot hybridization assay detected EBV excretion in four (8%) of the EBV-seropositive controls; three of these four were also positive by the lymphocyte transformation assay. Throat washings from seven (87.5%) of eight patients with acute infectious mononucleosis were positive by both assays. EBV was present in throat washings from 13 (50%) of 26 renal transplant recipients. For specimens stored at -70 C for less than four months, the dot hybridization assay had a sensitivity of 90% and a specificity of 98% when compared with the lymphocyte transformation assay. The dot hybridization assay is a rapid, sensitive, and specific test that can be performed on readily available clinical specimens.     

Impact of early nephrology referral on mortality and hospitalization in peritoneal dialysis patients.

OBJECTIVES: Several studies have examined the possible association between late referral to a nephrologist and mortality on maintenance hemodialysis. However, we lack information on the benefit of early nephrologist referral in patients receiving peritoneal dialysis (PD). PATIENTS AND METHODS: In an inception cohort of 102 consecutive PD patients identified in a single center between 2003 and 2004, we sought to determine whether late nephrologist referral was associated with poor outcomes. The primary end point was all-cause mortality. The effects of early referral to a multidisciplinary low clearance clinic on cardiovascular mortality and length of hospitalization were also evaluated. RESULTS: Of 102 incident PD patients, 61 subjects (59.8%) were referred early to the nephrologist (more than 3 months) before dialysis initiation. During the study period of 284.9 patient-years (median follow-up period 36.8 months), 25 patients died, 12 due to cardiovascular causes. Both cardiovascular and all-cause mortality were significantly increased among PD patients with late referral, but the relationship between late referral and all-cause mortality was mitigated substantially by adjusting for relevant factors. In univariate analysis, late nephrology referral was associated with increased cardiovascular mortality, with a hazard ratio of 5.43 (95% confidence interval 1.46 - 20.21, p = 0.012). Annual adjusted days of hospitalization were similar between the early and late nephrology referral groups. CONCLUSIONS: A comprehensive analysis of incident PD subjects confirmed the significant relationship between late nephrology referral and all-cause and cardiovascular mortality. A causal relationship remains to be established and validated.     

Chitosan-Alginate Scaffold Culture System for Hepatocellular Carcinoma Increases Malignancy and Drug Resistance

Purpose  

Hepatocellular carcinoma (HCC) is a prevalent solid malignancy. Critically needed discovery of new therapeutics has been hindered by lack of an in vitro cell culture system that can effectively represent the in vivo tumor microenvironment. To address this need, a 3D in vitro HCC model was developed using a biocompatible, chitosan-alginate (CA) scaffold cultured with human HCC cell lines.     

Clinical evaluation of psychiatric disorders among first-visit patients to a primary care unit

It is important for a primary care physician to know the most common psychiatric diagnoses, criteria for these diagnoses, and proper treatment. During a 4-month period from December 1987 to March 1988, the authors conducted this prospective study in a rural group practice center and investigated 189 first-visit patients aged from 16 to 60 years. Among them, 55 cases (29.1%) were diagnosed as having psychiatric disorders which included: psychological factors affecting physical condition, 29 cases; generalized anxiety disorder, 12 cases; adjustment disorder, 10 cases; and others, 4 cases. There were no significant differences in marital status, social class, or family structure between patients with and without psychiatric disorders. However, the patients with psychiatric disorders tended to have a longer duration of illness, to exhibit more salient features of introversion and neuroticism in their personalities, to show poorer family function and to experience more stressful life events. Although all the psychiatric patients presented somatic symptoms as their primary complaints, we also found that they reported significantly higher scores for psychiatric symptoms on a self-rating scale. This study demonstrates that in order to promote comprehensive primary health care, psychiatry and behavioral science are essential training curricula for family physicians.     

The use of intravenous gammaglobulin in the treatment of typical hemolytic uremic syndrome

Nine children with acute typical post-diarrhea hemolytic uremic syndrome (HUS) were treated with intravenous gammaglobulin (IVIG). These children were compared to nine children with HUS who did not receive IVIG. The use of IVIG did not appear to have a beneficial effect on eight of the nine treated children. There were no significant differences found in the duration of hemorrhagic colitis, thrombocytopenia, elevation of the white blood count (WBC), anuria, dialysis, or hospitalization, or the presence of a central nervous system complication or pancreatitis. Although no significant difference was found in the duration of thrombocytopenia, there was a trend towards a longer duration of thrombocytopenia in children treated with IVIG (P=0.13). One child demonstrated both an increase in her platelet count and a decrease in her WBC count within 24 h of receiving her first dose of IVIG.     

乳腺癌中ERK2、nm23、MMP9基因蛋白的表达及意义

目的探讨乳腺癌中ERK2基因蛋白表达与淋巴结转移相关基因nm23、MMP9蛋白表达的关系。方法采用HE染色光镜观察96例乳腺癌,用免疫组织化学技术检测病灶中ERK2、nm23、MMP9蛋白表达情况。结果ERK2蛋白表达在乳腺浸润性癌中有高于原位癌的趋势（χ^2=3.783,P=0.052）;nm23蛋白表达在淋巴结转移组中显著低于无淋巴结转移组（χ^2=9.222,P=0.010）,与ERK2蛋白表达呈显著负相关（χ^2=4.085,P=0.043）;MMP9蛋白表达在淋巴结转移组中显著性高于无淋巴结转移组（χ^2=4.153,P=0.043）,与ERK2蛋白表达无明显相关性（P〉0.05）。结论ERK2信号蛋白可能通过与nm23基因蛋白的作用影响乳腺癌的进展、淋巴结转移。